With so many cancer patients receiving therapies for treatment, there is a late effect being regularly experienced in a wide variety of patients called Cancer-Related Cognitive Impairment (CRCI) or Post Cancer Cognitive Impairment (PCCI). The American Cancer Society indicates that as of January 2016, there were 15.5 million people with a history of having cancer in the United States. It is estimated that worldwide, 14.1 million new cases of cancer are diagnosed annually with this number growing every successive year. CRCI is often referred to as “chemobrain” or “chemofog”. It’s estimated that nearly 75% of cancer patients may be affected by this issue. So, of the 15.5 million people in the US with a history of cancer, roughly 11.6 million will likely experience some aspect of it.
CRCI is a state of reduced mental functioning long after cancer treatment has commenced. Patients have reported bouts of short- and long-term memory loss, difficulty concentrating, confusion, and difficulty finding words to finish sentences, among other symptoms. Some investigations suggest that the impairment may start during cancer’s progression, rather than being a true result of treatment.
Unfortunately, because CRCI is not well understood, it is difficult to predict how long it might last if a patient is experiencing it. Equally difficult is predicting who will be affected and when. This condition can begin as early as during treatment or even 5-10 years after treatment has finished. It has lasting effects on survivors’ quality of life.
Symptoms of CRCI can only be managed by making adjustments to routines to help minimize the effects. Most recommend writing dates into a calendar and making notes or to-do lists for tasks. Keeping a journal of symptoms can help pinpoint if there are certain activities or times of the day that are harder like in the evening when one might be more tired and less able to focus. There is research in the literature suggesting that physical and mental exercises can reduce the “fog” affecting cognitive functioning. At this time, there is no drug approved to help reduce the impairment or decrease symptoms experienced.
Currently, CRCI is recognized as a condition that cancer patients and cancer survivors face. In a recent forum article in Trends in Neurosciences, the authors write that they are looking for a neuroscience approach to CRCI. There is a need for clinical neuropsychologists and neuroscience researchers to collaborate and develop approach models for individuals experiencing this condition. As detection and recognition of this condition improves, research can hopefully be designed to illuminate the factors at play and provide solutions for affected individuals who have already dealt with so much as cancer patients. If you are affected by this condition, talk to your provider in order to increase awareness of CRCI. If you are a researcher or provider, consider how your expertise could contribute to the body of knowledge related to this condition. Understanding the mechanisms involved and finding potential solutions will have a lasting impact on millions of people now and in future generations.